Impact of two early treatment protocols for anterior dental crossbite on children's quality of life

ABSTRACT Objective: To assess the impact of two early treatment protocols for anterior dental crossbite on children's quality of life. Methods: Thirty children, 8 to 10 years of age, with anterior dental crossbite, participated in this study. Individuals were divided into two groups: Group 1 - 15 children undergoing treatment with an upper removable appliance with digital springs; Group 2 - 15 children undergoing treatment with resin-reinforced glass ionomer cement bite pads on the lower first molars. Quality of life was evaluated using the Brazilian version of the Child Perceptions Questionnaire (CPQ8-10), which contains four subscales: oral symptoms (OS), functional limitations (FL), emotional well-being (EW), and social well-being (SW). A higher score denotes a greater negative impact on children's quality of life. Children answered the questionnaire before treatment (T1) and twelve months after orthodontic treatment onset (T2). Descriptive statistics, the Wilcoxon test and analysis of covariance (ANCOVA) were performed. Results: Children's mean age was 9.07 ± 0.79 years in Group 1 and 9.00 ± 0.84 years in Group 2. For Group 1, the FL and EW subscale scores and the overall CPQ8-10 were significantly higher in T1 as compared to T2 (p= 0.004, p= 0.012 and p= 0.015, respectively). For Group 2, there were no statistically significant differences. The ANCOVA showed no significant difference regarding quality of life at T2 between groups, after controlling for quality of life measures at T1. Conclusions: The difference regarding the impact on quality of life between groups is not related to the protocol used.

RESUMO Objetivo: avaliar o impacto de dois protocolos de tratamento precoce para a mordida cruzada anterior dentária na qualidade de vida de crianças. Métodos: trinta crianças de 8 a 10 anos de idade com mordida cruzada anterior dentária participaram desse estudo. Os indivíduos foram divididos em dois grupos: Grupo 1 - 15 crianças em tratamento com aparelho removível superior com molas digitais; Grupo 2 - 15 crianças em tratamento com batentes de cimento de ionômero de vidro resinoso nos primeiros molares permanentes inferiores. A qualidade de vida foi avaliada por meio da versão brasileira do Child Perceptions Questionnaire (CPQ8-10), o qual contém quatro subescalas: sintomas bucais (SB), limitações funcionais (LF), bem-estar emocional (BE) e bem-estar social (BS). Um escore mais alto indica um impacto mais negativo na qualidade de vida. As crianças responderam ao questionário antes do tratamento (T1) e 12 meses após o início do tratamento ortodôntico (T2). Estatística descritiva, o teste Wilcoxon e análise de covariância (ANCOVA) foram realizados. Resultados: a média de idade das crianças foi de 9,07 ± 0,79 anos no Grupo 1 e de 9,00 ± 0,84 no Grupo 2. Para o Grupo 1, os escores das subescalas LF e BE e o escore total do CPQ8-10 foram significativamente maiores em T1 do que em T2 (p= 0,004, p= 0,012 e p= 0,015, respectivamente). Para o Grupo 2, não houve diferença estatisticamente significativa. A ANCOVA não mostrou diferença significativa entre os grupos em relação à qualidade de vida em T2, após o controle para as medidas de qualidade de vida em T1. Conclusões: a diferença em relação ao impacto na qualidade de vida entre os grupos não foi relacionada ao protocolo de tratamento utilizado.

Comparação de dois protocolos de tratamento precoce da mordida cruzada anterior dentária / Comparasion of two early treatment protocols of anterior dental crossbite

Introdução: A mordida cruzada anterior dentária é definida como uma má oclusão no sentido sagital resultante da posição lingual dos incisivos superiores em relação aos inferiores. Esta má oclusão pode ser corrigida precocemente na dentadura mista usando-se diferentes protocolos de tratamento interceptativo propostos na literatura. Objetivos: 1) comparar a eficácia de dois protocolos de tratamento precoce da mordida cruzada anterior dentária. 2) comparar o impacto destes dois protocolos de tratamento na qualidade de vida de crianças. Materiais e métodos: Nesta tese foram apresentados, além das considerações iniciais e finais sobre o assunto e metodologia expandida do projeto de pesquisa, dois artigos científicos que contaram com uma amostra de 30 crianças de 8 a 10 anos divididas em dois grupos: Grupo 1 - 15 crianças tratadas com aparelho removível superior com molas digitais posicionadas na face palatina dos elementos cruzados e Grupo 2 - 15 crianças tratadas com batente de cimento de ionômero de vidro resinoso na oclusal dos primeiros molares permanentes inferiores promovendo a desoclusão e a movimentação dos dentes cruzados por ação da língua. No primeiro artigo, a comparação da eficácia dos protocolos foi realizada através da avaliação do overjet, perímetro do arco superior, distância intercaninos na maxila e mandíbula, SNA, SNB e ANB. No segundo artigo, a avaliação da qualidade de vida dos participantes foi realizada por meio da versão brasileira do instrumento Child Perceptions Questionnaire (CPQ8-10). Nos dois artigos, os 30 participantes foram avaliados antes do tratamento (T1) e 12 meses após a instalação dos protocolos (T2). Resultados: No primeiro artigo, o Grupo 1 mostrou um aumento significativo do overjet (P < 0,001), da distância intercaninos na maxila (P = 0,006) e da distância intercaninos da mandíbula (P = 0,031). O Grupo 2 mostrou um aumento significativo do overjet (P = 0,008) e da distância intercaninos na mandíbula (P = 0,005). Para todas as variáveis avaliadas, não houve diferenças estatisticamente significativas entre os dois grupos. No segundo artigo, para o Grupo 1, os escores das subescalas LF e BE e o escore total do CPQ8-10 foram significativamente maiores em T1 quando comparados com T2 (P = 0,004, P = 0,012 e P = 0,015 respectivamente). Para o Grupo 2, não houve diferenças estatisticamente significativas. Conclusões: No primeiro artigo, concluiu-se que a mordida cruzada anterior dentária na dentadura mista pode ser corrigida com sucesso pelos dois protocolos de tratamento propostos. No segundo artigo, conclui-se que o tratamento com aparelho removível superior com molas digitais esteve associado a alterações mais positivas da qualidade de vida das crianças

Introduction: The anterior dental crossbite is defined as a malocclusion resulting in sagittal direction of the lingual position of the upper incisors in relation to the lower. This malocclusion can be corrected early in mixed dentition using different interceptive treatment protocols proposed in the literature. Objectives: 1) to compare the efficacy of two early treatment protocols of previous dental crossbite. 2) compare the impact of these two treatment protocols in the quality of life of children. Materials and Methods: In this thesis were presented in addition to the initial and final thoughts on the subject and extended methodology of the research project, two scientific papers which involved a sample of 30 children aged 8 to 10 years divided into two groups: Group 1 - 15 children treated with upper removable appliance with digital springs positioned in the palatal face of the cross elements and Group 2 - 15 children treated with resin glass ionomer cement stop on the occlusal of the lower first permanent molars promoting disclusion and the movement of cross-teeth tongue action. In the first article, the comparison of the effectiveness of the protocols was carried out by assessing the overjet, upper arch perimeter, intercanine distance in the maxilla and mandible, SNA, SNB and ANB. In the second article, the evaluation of the quality of life of participants was carried out by the Brazilian version of the instrument Child Perceptions Questionnaire (CPQ8-10). In both articles, the 30 participants were evaluated before treatment (T1) and 12 months after the installation of protocols (T2). Results: In the first article, Group 1 showed a significant increase in overjet (p <0.001) of the distance intercanine jaw (p = 0.006) and intercanine distance from the jaw (p = 0.031). Group 2 showed a significant increase in overjet (p = 0.008) and intercanine distance jaw (p = 0.005). For all variables, no statistically significant differences between the two groups. In the second article, for Group 1, the scores of the subscales LF and BE and the total score of CPQ8-10 were significantly higher in T1 compared to T2 (p = 0.004, p = 0.012 and p = 0.015 respectively). For Group 2, there were no statistically significant differences. Conclusions: In the first article, it was concluded that the anterior dental crossbite in mixed dentition can be corrected successfully by the two proposed treatment protocols. In the second article, it is concluded that treatment with upper removable appliance with digital springs was associated with more positive changes in the quality of life of children

Prevalence and predictive factors of sleep bruxism in children with and without cognitive impairment

Studies have found a higher prevalence of sleep bruxism (SB) in individuals with cognitive impairment. The aim of this study was to identify the prevalence and factors associated with the clinical manifestation of SB in children with and without cognitive impairment. The sample was made up of 180 individuals: Group 1 - without cognitive impairment; Group 2 - with Down syndrome; Group 3 - with cerebral palsy. Malocclusions were assessed based on the Dental Aesthetic Index (DAI); lip competence was assessed based on Ballard's description. The bio-psychosocial characteristics were assessed via a questionnaire and clinical exam. Statistical analysis involved the chi-square test (p < 0.05) and multivariate logistic regression. The prevalence of bruxism was 23 percent. There were no significant differences between the groups (p = 0.970). Individuals with sucking habits (OR [95 percent CI] = 4.44 [1.5 to 13.0]), posterior crossbite (OR [95 percent CI] = 3.04 [1.2 to 7.5]) and tooth wear facets (OR [95 percent CI] = 3.32 [1.2 to 8.7]) had a greater chance of exhibiting SB. Sucking habits, posterior crossbite and tooth wear facets were identified as being directly associated with the clinical manifestations of bruxism.

Dental trauma in individuals with severe cerebral palsy: prevalence and associated factors

The aim of the present study was to determine the prevalence of dental trauma and associated factors among a sample of patients with severe cerebral palsy. The sample was made up of 120 individuals equally divided into two groups. The group with cerebral palsy was made up of 60 patients diagnosed with the spastic form of the disease. The control group was made up of 60 individuals with no mental impairment. Questionnaires were used to collect information on individual, socioeconomic and behavioral characteristics. Dental trauma was assessed based on the clinical chart of each participant, on a questionnaire and on a clinical evaluation to determine past injuries. Mouth mirrors and millimeter periodontal probes (Community Periodontal Index probe) were used to measure overjet. Lip seal and breathing type were determined during the clinical exams and interviews. Statistical analysis involved the chi-square test (p < 0.05) and multivariate logistic regression (forward stepwise procedure). The prevalence of dental trauma was greater among individuals with cerebral palsy (18 percent) than in the control group (5 percent), with the difference achieving statistical significance (p = 0.023). Individuals with lip incompetence had a greater chance of exhibiting dental trauma (OR [CI 95 percent] = 3.81 [1.19-12.24]). The prevalence of dental trauma among individuals with cerebral palsy was high. A lack of lip seal was identified as a factor directly associated to this prevalence.